scholarly journals Clinical utility of the BioFire FilmArray Blood Culture Identification panel in the adjustment of empiric antimicrobial therapy in the critically ill septic patient

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254389
Author(s):  
Roxanne Rule ◽  
Fathima Paruk ◽  
Piet Becker ◽  
Matthew Neuhoff ◽  
Julian Chausse ◽  
...  

Sepsis and septic shock are key contributors to mortality in critically ill patients and thus prompt recognition and management thereof is central to achieving improved patient outcomes. Early initiation of appropriate antimicrobial therapy constitutes a crucial component of the management strategy and thus early identification of the causative pathogen is essential in informing antimicrobial therapeutic choices. The BioFire FilmArray blood culture identification (BCID) panel is a US Food and Drug Administration (FDA) approved rapid, multiplex polymerase chain reaction assay for use on positive blood cultures. This study evaluated its clinical utility in the intensive care unit (ICU) setting, in terms of amendment of empiric antimicrobial therapy in critically ill patients with sepsis. The assay proved useful in this setting as final results were made available to clinicians significantly earlier than with conventional culture methods. This, in turn, allowed for modification of empirical antimicrobial therapy to more appropriate agents in 32% of patients. Additionally, the use of the BioFire FilmArray BCID panel permitted the prompt implementation of additional infection prevention and control practices in a sizeable proportion (14%) of patients in the study who were harbouring multidrug resistant pathogens. These findings support the use of the BioFire FilmArray BCID panel as a valuable adjunct to conventional culture methods for the diagnosis and subsequent management of critically ill patients with sepsis.

2021 ◽  
Vol 189 ◽  
pp. 106303
Author(s):  
Roxanne Rule ◽  
Fathima Paruk ◽  
Piet Becker ◽  
Matthew Neuhoff ◽  
Julian Chausse ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Bangchuan Hu ◽  
Yue Tao ◽  
Ziqiang Shao ◽  
Yang Zheng ◽  
Run Zhang ◽  
...  

Metagenomic next-generation sequencing (mNGS) and droplet digital PCR (ddPCR) have recently demonstrated a great potential for pathogen detection. However, few studies have been undertaken to compare these two nucleic acid detection methods for identifying pathogens in patients with bloodstream infections (BSIs). This prospective study was thus conducted to compare these two methods for diagnostic applications in a clinical setting for critically ill patients with suspected BSIs. Upon suspicion of BSIs, whole blood samples were simultaneously drawn for ddPCR covering 20 common isolated pathogens and four antimicrobial resistance (AMR) genes, mNGS, and blood culture. Then, a head-to-head comparison was performed between ddPCR and mNGS. A total of 60 episodes of suspected BSIs were investigated in 45 critically ill patients, and ddPCR was positive in 50 (83.3%), mNGS in 41 (68.3%, not including viruses), and blood culture in 10 (16.7%) episodes. Of the 10 positive blood cultures, nine were concordantly identified by both mNGS and ddPCR methods. The head-to-head comparison showed that ddPCR was more rapid (~4 h vs. ~2 days) and sensitive (88 vs. 53 detectable pathogens) than mNGS within the detection range of ddPCR, while mNGS detected a broader range of pathogens (126 vs. 88 detectable pathogens, including viruses) than ddPCR. In addition, a total of 17 AMR genes, including 14 blaKPC and 3 mecA genes, were exclusively identified by ddPCR. Based on their respective limitations and strengths, the ddPCR method is more useful for rapid detection of common isolated pathogens as well as AMR genes in critically ill patients with suspected BSI, whereas mNGS testing is more appropriate for the diagnosis of BSI where classic microbiological or molecular diagnostic approaches fail to identify causative pathogens.


2005 ◽  
Vol 31 (5) ◽  
pp. 645-648 ◽  
Author(s):  
Michèle Tanguy ◽  
Philippe Seguin ◽  
Bruno Laviolle ◽  
Laurent Desbordes ◽  
Yannick Mallédant

2018 ◽  
Vol 46 (1) ◽  
pp. 328-328
Author(s):  
Holly Krohn ◽  
Jennifer Roth ◽  
Peter Colley ◽  
Geoffrey Funk ◽  
Michael Foreman

2015 ◽  
Vol 3 (S1) ◽  
Author(s):  
EH Verstraete ◽  
L Mahieu ◽  
JD' Haese ◽  
K De Coen ◽  
J Boelens ◽  
...  

2016 ◽  
Vol 44 (12) ◽  
pp. 240-240
Author(s):  
Melanie Smith ◽  
Michael Erdman ◽  
Jason Ferreira ◽  
Petra Aldridge ◽  
Christopher Jankowski

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